Healthcare Provider Details

I. General information

NPI: 1013356310
Provider Name (Legal Business Name): JEANNE RANDALE CONNER MN, APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3318 3RD AVE N
BILLINGS MT
59101
US

IV. Provider business mailing address

PO BOX 964 804 MCLEOD ST
BIG TIMBER MT
59011-0964
US

V. Phone/Fax

Practice location:
  • Phone: 406-248-3149
  • Fax: 406-245-6636
Mailing address:
  • Phone: 406-932-5134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-RN-LIC-23994
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: